Automated Symptom Alerts Reduce Postoperative Symptom Severity After Cancer Surgery: A Randomized Controlled Clinical Trial

Abstract

Frequent symptom monitoring with alerts to clinicians when symptoms became moderate or severe reduced symptom severity during the 4 weeks after thoracic surgery. Methods of automated symptom monitoring and triage may improve symptom control after major cancer surgery. These results should be confirmed in a larger study.

Do High Symptom Scores Trigger Clinical Actions? An Audit After Implementing Electronic Symptom Screening

“…40,41 However, several randomized trials have suggested that routinely providing oncology providers with symptom outcomes has several patient benefits, such as reduced symptom prevalence and severity and improved well-being. 4,5,[7][8][9]42,43 In contrast, our study was not randomized. Moreover, unlike the trials with a defined intervention after a predetermined screening threshold, our cancer centers implemented screening without clear care pathways or designated trained staff to handle problem scores, which is more indicative of real-world settings.…”

“…Standardized symptom assessment alone may be insufficient to demonstrably improve symptom management, but instead, in conjunction, requires that automated symptom alerts and/or management care plans are implemented and provided to clinicians when symptoms reach predetermined thresholds. 1,9,34 Second, the rate of symptom screening has been adopted as an indicator of quality of care in some settings. 19,28,32,[35][36][37] However, because our results demonstrate that high screening rates do not necessarily translate into high rates of symptom-related actions being taken, our results also suggest caution in interpreting screening rates alone as indicators of high-quality care.…”

“…Several randomized trials using electronic symptom reporting have suggested that routinely providing oncology providers with patient-reported symptom outcomes is beneficial, though the evidence is nuanced, with limitations to specific symptoms, particular tools or interventions, or nonsignificant results. [4][5][6][7][8][9] As a result of these nuanced results, the clinical processes related to symptom management practices are important to investigate, particularly the association between symptom screening and symptom-related clinical actions taken, which are the means to improve patient outcomes, for example reduce symptom burden. However, little empirical research exists describing whether and how implementing electronic, standardized, symptom screening affects clinical processes related to symptom management, such as whether patients reporting worse symptoms receive clinical actions more often.…”

A prospective study of the feasibility and acceptability of a web-based, electronic patient-reported outcomes system in assessing patient recovery after major gynecologic cancer surgery

“…Reducing the burden of treatment-related symptoms, especially after aggressive therapy, is an important cancer care goal; as a result, the National Institutes of Health (NIH), the Food and Drug Administration (FDA), and other regulatory agencies have recognized the importance of PRO in evaluating disease and treatment [3][4][5]. Recently, a randomized controlled clinical trial that assessed automated telephone-based monitoring in patients who underwent thoracotomy for lung cancer or lung metastasis demonstrated reduced symptom severity with this approach [6]. However, it is unclear whether those data can be generalized to other populations or procedures.…”

Development of a Web Portal for Physical Activity and Symptom Tracking in Oncology Patients: Protocol for a Prospective Cohort Study (Preprint)

“…Symptom tracking and reporting using PRO has been shown to improve patient outcomes in cancer care [12]. Historically, paper or phone based interactive voice response systems have been used [13][14][15]. The novel approach of using a WP for the collection and communication of PRO may provide a more effective platform for healthcare professionals to facilitate long-term behaviour change in cancer survivors.…”